Medicare & Medicaid in New Jersey (NJ)
2026 healthcare costs, coverage, and spending data for New Jersey.
$8,915
Spending/Capita
1,742,763
Medicare Enrollees
2,357,017
Medicaid Enrollees
6.0%
Uninsured Rate
Medicare Premiums in New Jersey
Part B Premium
$185/mo
Part D Premium (Avg)
$68/mo
Medigap Premium (Avg)
$315/mo
Medicaid Expansion: Yes - New Jersey expanded Medicaid under the ACA
Procedure Costs in New Jersey
Hospital
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Liver Transplant | $158,902 | $127,122 | $31,780 |
| Kidney Transplant | $97,718 | $78,175 | $19,544 |
| Heart Valve Replacement | $85,258 | $68,207 | $17,052 |
| Coronary Artery Bypass Graft (CABG) | $57,638 | $46,110 | $11,528 |
| Spinal Fusion | $52,688 | $42,150 | $10,538 |
| Defibrillator Implantation (ICD) | $46,805 | $37,444 | $9,361 |
| Total Hip Replacement | $30,805 | $24,644 | $6,161 |
| Pacemaker Implantation | $29,901 | $23,921 | $5,980 |
| Total Knee Replacement | $29,188 | $23,350 | $5,838 |
| Cardiac Catheterization with Stent | $28,111 | $22,489 | $5,622 |
| Sepsis Treatment | $27,523 | $22,018 | $5,505 |
| Hip Fracture Repair | $26,496 | $21,197 | $5,299 |
| Carotid Endarterectomy | $25,538 | $20,430 | $5,108 |
| Prostatectomy | $22,427 | $17,942 | $4,485 |
| Laminectomy | $21,578 | $17,262 | $4,316 |
Outpatient
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| TURP (Prostate) | $8,502 | $6,801 | $1,700 |
| Endoscopic Sinus Surgery | $7,973 | $6,378 | $1,595 |
| Lithotripsy (Kidney Stones) | $7,649 | $6,119 | $1,530 |
| Dialysis Access Surgery | $7,270 | $5,816 | $1,454 |
| Bunionectomy | $6,917 | $5,534 | $1,383 |
| Arthroscopic Knee Surgery | $6,760 | $5,408 | $1,352 |
| Septoplasty | $6,600 | $5,280 | $1,320 |
| Hemorrhoid Surgery | $5,958 | $4,767 | $1,192 |
| Tonsillectomy | $5,465 | $4,372 | $1,093 |
| Carpal Tunnel Release | $4,942 | $3,954 | $988 |
| Adenoidectomy | $4,697 | $3,757 | $939 |
| Bronchoscopy | $4,142 | $3,313 | $828 |
| Ganglion Cyst Removal | $4,067 | $3,254 | $813 |
| Pilonidal Cyst Surgery | $3,771 | $3,017 | $754 |
| Varicose Vein Treatment | $3,738 | $2,991 | $748 |
Imaging
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| PET Scan | $3,399 | $2,719 | $680 |
| Nuclear Stress Test | $2,300 | $1,840 | $460 |
| MRI Brain | $1,684 | $1,347 | $337 |
| CT Angiography | $1,566 | $1,253 | $313 |
| CT Scan Abdomen/Pelvis | $1,488 | $1,190 | $298 |
| MRI Spine (Cervical) | $1,468 | $1,175 | $294 |
| MRI Spine (Lumbar) | $1,393 | $1,114 | $279 |
| MRI Shoulder | $1,212 | $970 | $242 |
| MRI Knee | $1,147 | $917 | $229 |
| CT Scan Chest | $1,102 | $882 | $220 |
| Bone Scan | $1,083 | $866 | $217 |
| MRI Hip | $1,047 | $838 | $209 |
| CT Colonography (Virtual) | $988 | $791 | $198 |
| CT Scan Head | $693 | $554 | $139 |
| Arterial Doppler | $526 | $421 | $105 |
Physician/Office
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Sleep Study Consultation | $416 | $333 | $83 |
| Allergy Testing | $275 | $220 | $55 |
| Mammogram (Screening) | $259 | $259 | $0 |
| Annual Wellness Visit | $237 | $237 | $0 |
| Wound Care Visit | $228 | $182 | $46 |
| Psychiatry Visit | $214 | $171 | $43 |
| Bone Density Test (DEXA Scan) | $207 | $165 | $41 |
| Mental Health Counseling | $199 | $159 | $40 |
| Occupational Therapy Session | $178 | $142 | $36 |
| Vision Exam (Diabetic) | $170 | $136 | $34 |
| Shingles Vaccination | $160 | $160 | $0 |
| Office Visit (Established Patient) | $158 | $127 | $32 |
| Office Visit (New Patient) | $150 | $120 | $30 |
| Skin Cancer Screening | $144 | $115 | $29 |
| Podiatry Visit | $135 | $108 | $27 |
Laboratory
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Vitamin D Level | $55 | $44 | $11 |
| PSA (Prostate-Specific Antigen) | $49 | $39 | $10 |
| Thyroid Panel (TSH) | $48 | $38 | $10 |
| Blood Culture | $46 | $37 | $9 |
| Glucose Tolerance Test | $46 | $36 | $9 |
| Liver Function Panel | $43 | $34 | $9 |
| BNP (Heart Failure Marker) | $42 | $34 | $8 |
| Blood Type and Crossmatch | $41 | $33 | $8 |
| Comprehensive Metabolic Panel | $41 | $32 | $8 |
| Lipid Panel | $39 | $31 | $8 |
| Hemoglobin A1C | $37 | $30 | $7 |
| Troponin Level | $37 | $30 | $7 |
| B12 Level | $37 | $29 | $7 |
| Urine Drug Screen | $34 | $27 | $7 |
| Basic Metabolic Panel | $29 | $24 | $6 |
Compare New Jersey With Other States
Frequently Asked Questions
How much does Medicare spend per person in New Jersey?
In 2026, the average Medicare spending per beneficiary in New Jersey is $8,915.
How many people are enrolled in Medicare in New Jersey?
New Jersey has approximately 1,742,763 Medicare beneficiaries.
Did New Jersey expand Medicaid?
Yes, New Jersey expanded Medicaid under the Affordable Care Act.
What is the uninsured rate in New Jersey?
The uninsured rate in New Jersey is 6.0%.
What is the average Medigap premium in New Jersey?
The average Medigap (Medicare Supplement) premium in New Jersey is $315 per month.